Managing eczema in adults?

What is adult eczema?

Defining adult eczema

Eczema in adults refers to a group of chronic inflammatory skin diseases marked by intense itching and skin lesions forming plaques. These lesions can appear on various body parts and vary in severity. Common symptoms include skin dryness, itching, redness, swelling, oozing, blisters, and crusting¹ ². 
 Multiple types of eczema can occur in adults, and it's possible for an individual to have several types concurrently¹ ³.

Eczema vs. atopic dermatitis in adults¹ ⁴

While "eczema" and "atopic eczema" are often used interchangeably, they are not synonymous. Atopic eczema, or atopic dermatitis, is a specific type of eczema, but not all eczemas are atopic.  
Atopic eczema primarily affects infants and children and often resolves during adolescence. However, in 10 to 15% of cases, it persists into adulthood. In rare cases, atopic eczema first appears in adults. 

Common causes of eczema in adults

Common causes across most eczema types

The causes of adult eczema are multifactorial, involving a combination of genetic, immune, environmental, and psychological factors. 

The importance of pictures for identifying eczema in adults

The diagnosis of eczema in adults is primarily clinical, meaning that an examination of the skin and lesions by a dermatologist or general practitioner will usually suffice for diagnosing eczema¹. 
While they don't replace clinical examination, photos of eczema are a valuable diagnostic tool. 

Treating flare-ups 

During flare-ups, local treatment may be necessary. Doctors prescribe creams or ointments with topical corticosteroids to apply to the plaques to reduce inflammation and itching. 

Preventing flare-ups 

To prevent eczema flare-ups:  

• Regularly moisturize the skin with an emollient like DEXERYL Emollient Cream.
• Choose soft cotton or linen clothing and avoid wool or synthetic fibers. 
• Take brief, lukewarm showers with gentle, soap-free cleansers such as DEXERYL Cleansing Oil. 
• Maintain a cool temperature in the bedroom. 
• Avoid tobacco.
• To prevent infections due to scratching, keep nails short and avoid touching the lesions. 

Managing severe eczema

For severe eczema or when standard treatments prove ineffective, dermatologists may consider prescribing local or oral immunosuppressants, UVA/UVB phototherapy, or specialized treatments.

Effective management of adult eczema often necessitates a tailored approach under medical guidance. General practitioners are well-equipped to treat mild eczema, but a dermatologist's expertise may be required in certain situations, such as:  
Diagnostic uncertainty needing further investigation.  
Lack of improvement despite initial treatments prescribed by your GP.  
Moderate to severe eczema cases, potentially needing advanced care like phototherapy or systemic treatments.  
Escalating symptoms, like spreading, intensifying pain, or infection of the lesions.  
Adverse reactions to current treatments.  
Significant impact on quality of life, affecting sleep, mood, work, or social activities.  

Prompt consultation with a GP or a visit to the emergency department is advisable for complications like infected eczema lesions.